Q: "How does biological wear and tear of the adrenal glands manifest itself?"
This is sort of a Q&A, where I answer questions you ask or send to me.
The adrenal glands are two small organs located above the kidneys whose function is, quite simply, to produce stress-reacting hormones: cortisol, adrenaline and DHEA.
They are in a sense the control center for those responses and for our subsequent adaptation and recovery.
For this reason, they are glands in great demand in situations of stress, both acute and chronic. However, they are much better adapted for the first scenario: the acute response. We evolved by learning to develop immediate responses in response to being chased by a lion. Our survival depended on it.
One of the premises of these processes was that we had to use every tool to survive, sparing nothing at the risk of being hunted down. The other premise was that if we survived, we would have time and opportunity to rest, recover and recharge batteries. We would spend everything and recover.
The scenario nowadays is quite different: episodes of acute stress have been replaced by a spectrum of continuous stress.
Continual levels of stress (whether physical or mental, emotional or professional) force us to continually develop and execute stress responses. However, we don't have the capacity, availability or even time to recover - as we have been programmed to do.
We continue to pull at the system, driven by the need or desire to respond to the challenges that are set or imposed upon us.
This state leads us to consume more energy, more resources than we can recharge, causing a deficit. If in terms of electronic devices this deficit is measured in battery reserve, in biological terms we speak of "metabolic reserve".
All of our stress responses consume resources, both in the execution of the response and in the recovery and rebuilding phase.
We not only have to have the ability to act but to restore ourselves and return to the level of homeostasis, of healthy balance. These resources are neurotransmitters, co-factors and the hormones, in particular cortisol.
Giving time to time - and here time is defined in several years, the existence of this deficit leads to us no longer being able to perform at our best level, leading to breaks in health and performance.
It is the first step in a process that is technically called "dysfunction of thehypothalamic-pituitary-adrenal axis," better known as Burnout.
Simply put, Burnout is the "final" state of a condition characterised by an inability of our systems to act appropriately to the circumstances. In this chapter of stress, the adrenal glands are central.
"Biological attrition" is manifested by the inability to adequately produce cortisol, either in terms of daily quantity or in terms of the rate at which it is produced and released.
The spectrum of symptoms is quite wide, ranging from a greater difficulty in waking up with energy and needing more stimulants (like coffee) to get the "engine started" and feeling that you are in full cognitive, emotional and physical capacity, to a complete inability to function, a complete physical exhaustion.
In fact, this characteristic is one of the biggest problems associated with burnout - its nonspecificity, and it can often be misdiagnosed as a mental health problem, such as depression.
This is probably one of the most frustrating aspects of this scenario, preventing thousands of people from being properly helped: being treated as a mental health problem, when it is a systemic, global problem. The "mental" manifestation is just the tip of the iceberg.
How many great minds with great ideas and great projects have not changed the world because they were treated with antidepressants when what they needed was "just" to be given what they needed: the tools, the strategies and the opportunity to rest, recover and recharge their batteries.